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Updated: Jun 1, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
08:36

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Published on: August 8, 2019

Non-24-Hour Sleep-Wake Disorder in Children and Adolescents: A Case Series

Ruo Yan Chen1, Gurinder Grewal2, James Lee1

  • 1Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.

Behavioral Sleep Medicine
|May 31, 2026
PubMed

Insights

Pediatric non-24-hour sleep-wake disorder (N24SWD) in sighted children often co-occurs with neurodevelopmental issues. Standard treatments show limited success, suggesting a need for individualized, family-centered care for N24SWD management.

Area of Science:

  • Pediatric Sleep Medicine
  • Circadian Rhythm Disorders
  • Neurodevelopmental Disorders

Background:

  • Non-24-hour sleep-wake disorder (N24SWD) is a circadian rhythm disorder.
  • Pediatric N24SWD in sighted individuals is less understood than in blind populations.
  • Associated neurodevelopmental comorbidities can complicate diagnosis and management.

Purpose of the Study:

  • To characterize clinical features of N24SWD in sighted children.
  • To investigate comorbidities, diagnostic methods, and treatment outcomes.
  • To describe the challenges in managing pediatric N24SWD.

Main Methods:

  • Retrospective case series of six pediatric patients with N24SWD.
  • Clinical evaluation included patient history, sleep diaries, and actigraphy.
  • Assessment of treatment outcomes with melatonin, bright light therapy, and behavioral interventions.

Main Results:

  • All six patients were sighted and had N24SWD, with free-running sleep cycles (24-29 hours).
  • Common comorbidities included autism spectrum disorder, ADHD, and anxiety disorders.
  • Entrainment strategies had variable success; long-term success was rare due to side effects, adherence issues, and family burden. Flexible schedules were sometimes preferred.

Conclusions:

  • Pediatric N24SWD in sighted children is linked to neurodevelopmental disorders.
  • Current circadian-based treatments are challenging to sustain long-term.
  • Individualized, family-centered management and improved diagnostic tools are crucial for N24SWD.
Abstract

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